Blog | Wednesday, October 22, 2014

Medicare follies, or, the Annual Wellness Visit

Over the last few years, Medicare, the government insurance program for the elderly, has added a few benefits, one of them being a yearly doctor visit. This “Annual Wellness Visit“ is a great source of confusion around the office. Patients come in for a yearly wellness visit thinking that they are here for a “full physical.” They are not. The Annual Wellness Visit is something much more complicated and much less useful.

No one seems to agree on exactly how to run an AWV, but the basics are this: the patient fills out a questionnaire on their health; the doctor notes the patient’s basic data: age, blood pressure, body-mass index, etc. The patient is then assessed for their risk of falling, depression, and alcoholism, and their ability to take care of their basic needs. Their medications and other doctors are reviewed. After the visit they are supposed to receive a written plan detailing any prevention recommendations, such as mammograms, weight loss, etc.

Importantly, the AWV does not include a physical exam. I am not supposed to listen to your heart, feel your belly, or talk about your newly-diagnosed cancer. You have to make another appointment for that.

This sort of foolishness could only have been dreamed up by someone who doesn’t see patients. The AWV might as well be done at a self-serve computer station.

Peter A. Lipson, ACP Member, is a practicing internist and teaching physician in Southeast Michigan. After graduating from Rush Medical College in Chicago, he completed his internal medicine residency at Northwestern Memorial Hospital. This post first appeared at his blog at Forbes. His blog, which has been around in various forms since 2007, offers "musings on the intersection of science, medicine, and culture." His writing focuses on the difference between science-based medicine and "everything else," but also speaks to the day-to-day practice of medicine, fatherhood, and whatever else migrates from his head to his keyboard.